Individual provider Active NPI

Melinda B Goodman, PH.D

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1578879672
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4822 Issued in MD
Practice address
1414 Key Hwy
Ste 300M
Baltimore, MD 21230-5142
Phone
(352) 359-3227
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS016706 PA
Psychologist 103T00000X 4822 MD Primary

Addresses

Primary practice location

1414 Key Hwy
Ste 300M
Baltimore, MD 21230-5142

Mailing address

1414 Key Hwy
Ste 300M
Baltimore, MD 21230-5142
Phone (352) 359-3227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000637 MD Practitioner - Clinical Psychologist 8123216298 Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4822MDMDPsychologist
PS016706PAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Counseling LLC PastSince Aug 6, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1578879672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 KEY HWY",
            "address_2": "STE 300M",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305142",
            "telephone_number": "352-359-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 KEY HWY",
            "address_2": "STE 300M",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305142",
            "telephone_number": "352-359-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MELINDA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016706",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "4822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.